Philippon J, Nachanakian A, Fohanno D, Gardeur D, Metzger J
Neurochirurgie. 1982;28(6):367-71.
Stereotaxic biopsy of cerebral tumors has been considerably facilitated by the use of CT scanner. A new method is described using the CT section in the horizontal or oblique plan of biopsy. When this has been determined, it is possible to define a trajectory, calculated by the CT scan computer, with external landmarks marked on the skin. This method is possible with any kind of CT apparatus; the surgical biopsy is performed in the operating room with a simple stereotaxic frame square-shaped and fixed in the plan of the CT section. The biopsy needle may be oriented in an antero-posterior or medio-lateral direction. This method has been used in 33 patients, leading to as precise histological diagnosis in 30 cases. No complications have been noted, except for transient neurological deterioration in two cases, due to local edema. Hemorrhage have not been observed. The topographical precision of the method was verified by the injection of lcc of air followed by a post-biopsy CT scan. This technique seems particularly valuable for the diagnosis of deep or wide spread hemispheric tumors, non indicated for open surgery.
计算机断层扫描(CT)扫描仪的应用极大地推动了脑肿瘤的立体定向活检。本文描述了一种利用活检水平或斜位平面的CT断层图像的新方法。确定该平面后,即可通过CT扫描计算机计算出一条轨迹,并在皮肤上标记外部标志物。任何类型的CT设备都可采用这种方法;手术活检在手术室进行,使用一个简单的方形立体定向框架,并固定在CT断层图像平面上。活检针可沿前后或中外侧方向定向。该方法已应用于33例患者,30例获得了精确的组织学诊断。除两例因局部水肿导致短暂性神经功能恶化外,未发现其他并发症。未观察到出血情况。通过注入1立方厘米空气,随后进行活检后CT扫描,验证了该方法的定位精度。对于深部或广泛扩散的半球肿瘤,该技术似乎对那些不适合进行开放手术的病例的诊断特别有价值。